Evaluation of the effectiveness of electronic prescription in reducing medical and medical errors (systematic review study).

INTRODUCTION: The use of electronic systems in prescription is considered as the final solution to overcome the many problems of the paper transcription process, especially with the outbreak of Coronavirus needs more attention than before. But despite the many advantages, its implementation faces many challenges and obstacles. Therefore, the present study was conducted to review the effectiveness of computerized physician order entry systems (CPOE) on relative risk reduction on medication error and adverse drug events (ADE). METHOD: This study is one of the systematic review studies that was conducted in 2021. In this study, searching for keywords such as E-Electronic Prescription, Patient safety, Medication Errors prescription, Drug Interactions, orginal articles from 2000 to October-2020 in the valid databases such as ISI web of Science PubMed Embase, Scopus and search engines like google was done. The included studies were based on the main objectives of the study and based on the inclusion criteria after several stages of review and quality evaluation. In fact, the main criteria for selecting articles were studies that compared the rate of medication errors with or without assessing the associated harms (real or potential) before and after the implementation of EMS. RESULTS: Out of 110 selected studies after initial screening, only 16 articles were selected due to their relevance. Among the final studies, there was a significant heterogeneity. Only 6 studies were of good quality. Of the 10 studies prescribing error rates, 9 reported reductions, but variable denominators prevented meta-analysis. Twelve studies provided specific examples of systemic drug errors. 5 cases reported their occurrence slightly. Out of 9 cases that analyzed the effects on drug error rate, 7 cases showed a significant relative reduction between 13 and 99%. Four of the six studies that analyzed the effects on potential ADEs showed a significant relative reduction of between 35 and 98%. Two of the four studies that analyzed the effect of ADEs showed a relative reduction of between 30 and 84%. CONCLUSION: Finally, e-prescribing seems to reduce the risk of medication errors and ADE. However, the studies differed significantly in terms of setting, design, quality and results. More randomized controlled trials (RCTs) are needed to further improve the evidence of health informatics information.

Smartphone Use and its Impact on Ocular Health among University Students in Saudi Arabia.

BACKGROUND: People are increasingly using mobile phones rather than fixed telephones. Nearly everyone has a mobile phone and the vast majority of these are smartphone. The patterns of smartphone activities may put a significant number of populations especially students at risk of negative ocular problems. To determine the prevalence, pattern, and impact of smartphone use on ocular health among University students. METHODS: A cross-sectional study was conducted and 760 male and female students were selected from Medical and Pharmacy Colleges by multistage random sampling. A self-administered structured questionnaire including sociodemographic and visual manifestations data was used to collect data. SPSS program version 22 was used to analyze data. RESULTS: Out of 760 students selected, 546 (71.8%) responded. The overall prevalence of smartphone use was 90.84%. However, the age range for the beginning of smartphone use was 12-18 years old (68.3%). In addition, the daily duration of smartphone use was 4-6 h/day (30.2%). Furthermore, females believed that they use smartphone more than usual compared to males. Moreover, ocular pain and/or dryness after prolonged time spent on smartphone use were more among smartphone users (39.7%). Finally, most of the students (66.0%) had one or more ocular problems after smartphone use. CONCLUSIONS: There is an association between smartphone use and occurrence of ocular manifestations. Health education programs on smartphone use and its ocular hazards are highly recommended.

DNA Import into Mitochondria.

In recent decades, it has become evident that the condition for normal functioning of mitochondria in higher eukaryotes is the presence of membrane transport systems of macromolecules (proteins and nucleic acids). Natural competence of the mitochondria in plants, animals, and yeasts to actively uptake DNA may be directly related to horizontal gene transfer into these organelles occurring at much higher rate compared to the nuclear and chloroplast genomes. However, in contrast with import of proteins and tRNAs, little is known about the biological role and molecular mechanism underlying import of DNA into eukaryotic mitochondria. In this review, we discuss current state of investigations in this area, particularly specificity of DNA import into mitochondria and its features in plants, animals, and yeasts; a tentative mechanism of DNA import across the mitochondrial outer and inner membranes; experimental data evidencing several existing, but not yet fully understood mechanisms of DNA transfer into mitochondria. Currently available data regarding transport of informational macromolecules (DNA, RNA, and proteins) into the mitochondria do not rule out that the mechanism of protein and tRNA import as well as tRNA and DNA import into the mitochondria may partially overlap.

Response of Triple Negative Breast Cancer to Neoadjuvant Chemotherapy: Correlation between Ki-67 Expression and Pathological Response.

Triple-negative breast cancers constitute about 15% of all cases, but despite their higher response to neoadjuvant chemotherapy, the tumors are very aggressive and associated with a poor prognosis as well as a higher risk of early recurrence. This study was retrospectively performed on 101 patients with stage II and III invasive breast cancer who received 6-8 cycles of neo-adjuvant chemotherapy. Out of the total, 23 were in the triple negative breast cancer subgroup. Nuclear Ki-67 expression in both the large cohort group (n=101) and triple negative breast cancer subgroup (n=23) and its relation to the pathological response were evaluated. The purpose of the study was to identify the predictive value of nuclear protein Ki-67 expression among patients with invasive breast cancers, involving the triple negative breast cancer subgroup, treated with neoadjuvant chemotherapy in correlation to the rate of pathological complete response. The proliferation marker Ki-67 expression was highest in the triple negative breast cancer subgroup. No appreciable difference in the rate of Ki-67 expression in triple negative breast cancer subgroup using either a cutoff of 14% or 35%. Triple negative breast cancer subgroup showed lower rates of pathological complete response. Achievement of pathological complete response was significantly correlated with smaller tumor size and higher Ki-67 expression. The majority of triple negative breast cancer cases achieved pathological partial response. The study concluded that Ki-67 is a useful tool to predict chemosensitivity in the setting of neoadjuvant chemotherapy for invasive breast cancer but not for the triple negative breast cancer subgroup.

Estimation of congestion in free disposal hull models using data envelopment analysis.

This paper deals with evaluating congestion in free disposal hull (FDH) models. There are several approaches in data envelopment analysis (DEA) literatures which discuss the theory and application of congestion. However, almost all of these approaches considered convex DEA technologies. So, in the case of nonconvex technologies, including FDH technology, this field is almost nil. This paper makes an attempt to fill in this void. To do so, this study provides a pairwise comparisons-based algorithm to evaluate congestion in FDH model. This algorithm identifies the sources of congestion and estimates its amounts. It is also capable of detecting the losses amounts of output due to congestion. The validity of the proposed model is demonstrated using some numerical and empirical examples.

Reform in medical and health sciences educational system: a Delphi study of faculty members' views at Shiraz University of Medical Sciences.

Despite the strengths in the Iranian medical and health sciences educational system, areas in need of improvement have been noted. The purpose of this study was to understand the views of faculty members at Shiraz University of Medical Sciences about current and future needs for medical and health sciences education, with the goal of improving the quality of the educational system. The data were collected using a Delphi consensus method. Analysis of the findings identified the following key themes among the factors likely to contribute to medical and health sciences education and training: adding and/or increasing student numbers in higher degrees in preference to associate degrees; providing more interactive, student-centred teaching methods; improving the educational content with more practical and research-based courses tailored to society's needs; and an emphasis on outcome-based student evaluation techniques. These changes aim to respond to health trends in society and enhance the close relationship between medical education and the needs of the Iranian society.

Hybrid metaheuristics for solving a fuzzy single batch-processing machine scheduling problem.

This paper deals with a problem of minimizing total weighted tardiness of jobs in a real-world single batch-processing machine (SBPM) scheduling in the presence of fuzzy due date. In this paper, first a fuzzy mixed integer linear programming model is developed. Then, due to the complexity of the problem, which is NP-hard, we design two hybrid metaheuristics called GA-VNS and VNS-SA applying the advantages of genetic algorithm (GA), variable neighborhood search (VNS), and simulated annealing (SA) frameworks. Besides, we propose three fuzzy earliest due date heuristics to solve the given problem. Through computational experiments with several random test problems, a robust calibration is applied on the parameters. Finally, computational results on different-scale test problems are presented to compare the proposed algorithms.

Using enhanced Russell model to solve inverse data envelopment analysis problems.

This paper studies the inverse data envelopment analysis using the nonradial enhanced Russell model. Necessary and sufficient conditions for inputs/outputs determination are introduced based on Pareto solutions of multiple-objective linear programming. In addition, an approach is investigated to identify extra input/lack output in each of input/output components (maximum/minimum reduction/increase amounts in each a of input/output components). In addition, the following question is addressed: if among a group of DMUs, it is required to increase inputs and outputs to a particular unit and assume that the DMU maintains its current efficiency level with respect to other DMUs, how much should the inputs and outputs of the DMU increase? This question is discussed as inverse data envelopment analysis problems, and a technique is suggested to answer this question. Necessary and sufficient conditions are established by employing Pareto solutions of multiple-objective linear programming as well.

Reform in medical and health sciences educational system:a Delphi study of faculty members' views at Shiraz University of Medical Sciences

Despite the strengths in the Iranian medical and health sciences educational system, areas in need of improvement have been noted.The purpose of this study was to understand the views of faculty members at Shiraz University of Medical Sciences about current and future needs for medical and health sciences education, with the goal of improving the quality of the educational system.The data were collected using a Delphi consensus method.Analysis of the findings identified the following key themes among the factors likely to contribute to medical and health sciences education and training:adding and/or increasing student numbers in higher degrees in preference to associate degrees; providing more interactive, student-centred teaching methods; improving the educational content with more practical and research-based courses tailored to society's needs; and an emphasis on outcome-based student evaluation techniques.These changes aim to respond to health trends in society and enhance the close relationship between medical education and the needs of the Iranian society

على الرغم من مواطن القوة في النظام التعليمي الإيراني للعلوم الصحية والطبية، فإن هناك مجالات يتعين تحسينها.وتهدف هذه الدراسة إلى فهم وجهات نظر أعضاء هيئة التدريس في جامعة شيراز للعلوم الطبية حول الاحتياجات الحالية والمستقبلية في التعليم الصحي والطبي، بهدف تحسين جودة النظام التعليمي. وقد جمع الباحثون البيانات بطريقة الإجماع دلفي. وحددت النتائج أن المواضيع الرئيسية التالية هي من بين العوامل التي يغلب أن تساهم في التعليم والتدريب في العلوم الصحية والطبية: إضافة أو زيادة أعداد الطلاب في الدرجات العالية لصالح الدرجات الإضافية، تقديم المزيد من طرق التعليم التفاعلية والمتمحورة حول الطلاب، تحسين المضمون التعليمي بإضافة دورات عملية تستند على البحوث ومصممة لتلبية احتياجات المجتمع، والتأكيد على تقنيات تقييم التلاميذ استنادا إلى النتائج. وتهدف هذه التغيرات للاستجابة للاتجاه الصحي السائد في المجتمع ولتعزيز العلاقة الصميمية بين التعليم الطبي وبين احتياجات المجتمع الإيراني

Malgré les aspects positifs du système iranien d'enseignement de la médecine et des sciences de la santé, certains domaines nécessitant une amélioration ont été identifiés.La présente étude visait à comprendre les points de vue des membres du corps enseignant de l'Université des Sciences médicales de Chiraz sur les besoins présents et à venir de l'enseignement de la médecine et des sciences de la santé, avec pour objectif d'améliorer la qualité du système d'enseignement.Les données ont été recueillies à l'aide de la méthode de consensus Delphi.L'analyse des résultats a permis de dégager les thèmes clés suivants parmi les facteurs susceptibles de contribuer à l'enseignement de la médecine et des sciences de la santé ainsi qu'à la formation en la matière:augmenter le nombre d'étudiants dans les années d'études supérieures plutôt dans que celles des diplômes d'études générales; proposer davantage de méthodes d'enseignement interactives et axées sur l'étudiant; améliorer le contenu de l'enseignement par des cours davantage centres sur la pratique et la recherche et adaptés aux besoins de la société; et privilégier les techniques d'évaluation de l'étudiant reposant sur les résultats.Ces changements visent à répondre aux tendances en matière de santé dans la société et à renforcer le lien étroit entre l'enseignement de la médecine et les besoins de la société iranienne

Reduction of metabolic signs of acute stress in male mice by Papaver rhoaes hydro-alcoholic extract.

In the present study, effects of hydro-alcoholic extract of Papaver rhoeas L. (Papaveraceae) on the metabolic changes induced by electro foot shock stress in male NMRI mice (25-30 g) has been investigated. The mice were received electric foot shock (40 mV) for 100 sec. Plasma corticosterone levels, food and water intake and delay to eating (Anorexia) were assessed 20 min later. Different doses of the plant extract (15, 30 and 60 mg kg(-1)), or saline (10 mL kg(-1)) was injected to the animals intraperitoneally 30 min before the stress. The control groups received saline (10 mL kg(-1)) or the extract (15, 30 and 60 mg kg(-1)) and 30 min later were exposed to the apparatus but did not received stress. Our results indicated that stress can increase plasma corticosterone level significantly and the extract can exacerbate the stress effect. However, stress could reduce food and water intake and increase delay to eating times which were inhibited by the extract pretreatment. The results indicate that administration of the extract of Papaver rhoeas can reduce the side effects of stress but increases plasma corticosterone level which may be due to its effects on the adrenal gland.

Research priorities in medical education in the Eastern Mediterranean Region.

Ways are needed to effect quality improvement in medical education research in the Eastern Mediterranean Region (EMR). This study aimed to determine the principle themes and to draw up a list of priorities in medical education research in EMR. Using the nominal group technique with a group of 30 experts, a list of major themes in medical education research was prepared. In a 2-round Delphi survey the list was sent to another 47 experts in the Region with a questionnaire that included open questions about change and reform in medical education. In the final list of 20, the 5 highest priorities identified were: training physicians to be effective teachers; community-driven models for curriculum development; clinical teaching models; education about professionalism and ethics; and education for evidence-based medicine. Themes determined by this survey can help researchers in EMR to focus on priority areas in research.

Research priorities in medical education in the Eastern Mediterranean Region

Ways are needed to effect quality improvement in medical education research in the Eastern Mediterranean Region [EMR]. This study aimed to determine the principle themes and to draw up a list of priorities in medical education research in EMR. Using the nominal group technique with a group of 30 experts, a list of major themes in medical education research was prepared. In a 2-round Delphi survey the list was sent to another 47 experts in the Region with a questionnaire that included open questions about change and reform in medical education. In the final list of 20, the 5 highest priorities identified were: training physicians to be effective teachers; community-driven models for curriculum development; clinical teaching models; education about professionalism and ethics; and education for evidence-based medicine. Themes determined by this survey can help researchers in EMR to focus on priority areas in research

Evolution of a new surface water quality index for Karoon catchment in Iran.

Water quality standards are developed worldwide by national and international agencies for pollution control decision-making. Use-based water quality classification criteria and Water Quality Indices (WQIs) also play an important role in the assessment of the suitability of water resources for various applications. The present study proposes a better overall index for water quality in Iran and its application in Karoon River by exploring the behavior and limitations of conventional methods for quality evaluation. For this purpose, six variables were employed. Water quality determinants of the new index include Dissolved Oxygen, Total Dissolved Solids, Turbidity, Nitrate, Fecal coliform and pH. Besides, the mathematical equations applied to transform the actual concentration values into quality indices have been formulated. This study compares a new index called the Iranian Water Quality Index with other pre-existing indices such as NSFWQI, Oregon, CPCB WQI, MDOE WQI, Kaurish and Younos WQI, and Ahmed Said WQI. Results revealed that the overall quality of the surface water falls under the 'good' class. A case study of Karoon River is made to illustrate the application of this new index system.

Development of a model to assess environmental performance, concerning HSE-MS principles.

The main objective of the present study was to develop a valid and appropriate model to evaluate companies' efficiency and environmental performance, concerning health, safety, and environmental management system principles. The proposed model overcomes the shortcomings of the previous models developed in this area. This model has been designed on the basis of a mathematical method known as Data Envelopment Analysis (DEA). In order to differentiate high-performing companies from weak ones, one of DEA nonradial models named as enhanced Russell graph efficiency measure has been applied. Since some of the environmental performance indicators cannot be controlled by companies' managers, it was necessary to develop the model in a way that it could be applied when discretionary and/or nondiscretionary factors were involved. The model, then, has been modified on a real case that comprised 12 oil and gas general contractors. The results showed the relative efficiency, inefficiency sources, and the rank of contractors.

Specific plant DNA adducts as molecular biomarkers of genotoxic atmospheric environments.

The general purpose of this study was to determine whether the formation of DNA addition products ('adducts') in plants could be a valuable biomarker of genotoxic air pollution. Plants from several species were exposed to ambient atmosphere at urban and suburban sites representative of different environmental conditions. The levels of NO2 and of the quantitatively major genotoxic air pollutants benzene, toluene, and xylene were monitored in parallel with plant exposure. DNA adducts were measured in bean (Phaseolus vulgaris), rye-grass (Lolium perenne), and tobacco (Nicotiana tabacum) seedlings by means of the [32P]-postlabeling method. Whereas, no correlation was found between the levels of the major genotoxic air pollutants and the total amounts of DNA adducts, individual analyses revealed site-specific and plant species-specific adduct responses, both at the qualitative and quantitative level. Among these, the amount of a specific rye-grass DNA adduct (rgs1) correlated with benzene/toluene/xylene levels above a threshold. For further characterization, rye-grass seedlings were treated in controlled conditions with benzene, toluene, xylene or their derivatives. On the other hand, in vitro DNA adduct formation assays were developed involving benzene, toluene, xylene, or their derivatives, and plant microsomes or purified peroxidase. Although in some cases, these approaches produced specific adduct responses, they failed to generate the rgs1 DNA adduct, which appeared to be characteristic for on-site test-plant exposure. Our studies have thus identified an interesting candidate for further analysis of environmental biomarkers of genotoxicity.

Mormyrogyrodactylus gemini gen. et sp. n. (Monogenea: Gyrodactylidae), a new gyrodactylid from Marcusenius macrolepidotus (Mormyridae) from South Africa.

Mormyrogyrodactylus gemini gen. et sp. n. (Gyrodactylidea: Gyrodactylidae), a viviparous monogenean is described from the skin and fins of Marcusenius macrolepidotus (Peters) from South Africa. This new genus is unique in having a large cup-shaped cirrus armed with one large needle-like spine and numerous small hair-like spinelets. A peduncular bar is present. The haptor is clearly demarcated from the body and situated on a small pedicle. The haptor has one pair of large anchors, a ventral bar complex, a small dorsal bar and 16 evenly spaced marginal hooks. The ventral bar complex consists of three parts: an inverted U-shaped piece with two semi-attached bars, each bar consisting of a base and an extension. An accessory inverted T-shaped sclerite is present on the posterior rim of the haptor. Mormyrogyrodactylus is the fifth genus of the Gyrodactylidae to be described from Africa.

The open reading frame 1-encoded ('36K') protein of Carnation Italian ringspot virus localizes to mitochondria.

The localization of the 36 kDa ('36K') protein encoded by open reading frame 1 of Carnation Italian ringspot virus was studied in infected cells and in cells transiently expressing the 36K protein fused to green fluorescent protein (GFP). Subcellular fractionation demonstrated that the 36K protein accumulated in fractions containing mostly mitochondria. Fluorescence microscopy of transiently transformed cells showed that the 36K-GFP fusion protein accumulated in structures which could be stained with the mitochondrial-specific dye MitoTracker. However, these structures were larger than normal mitochondria and were irregular in shape and distribution in the cytoplasm. Electron microscopy showed severe alterations of mitochondria, which were often clumped. The stroma was more electron-opaque, the cristae were irregularly shaped, the intermembrane space was enlarged and the outer membrane was covered with an electron-dense amorphous material whose nature could not be determined. The organelle-targeted 36K protein seems to promote the overgrowth of the mitochondrial outer membrane.

Localization of tRNA genes on the Petunia hybrida 3704 mitochondrial genome.

22 tRNA genes corresponding to 17 tRNA species were localized on the master circle of Petunia hybrida mitochondrial (mt) DNA. Genes for trnN, trnM, trnS-GGA, trnW and trnH are of the 'chloroplast-like' type and presumably originate from promiscuous chloroplast (cp) DNA sequences inserted into the petunia mitochondrial genome. A comparison of the mt tRNAs or tRNA genes population present in two monocotyledonous plants (wheat and maize) and two dicotyledonous plants (petunia and potato) show slight differences in the genetic origin of individual tRNAs. The organization of the petunia mt tRNA genes as well as the number of tRNA gene copies, compared to other plant species, is discussed.

DNA adduct detection: some applications in monitoring exposure to environmental genotoxic chemicals.

In the assessment of genotoxic risk factors in the environment, the measurement of DNA adducts in aquatic organisms and in plants may have considerable implications. Using 32P-postlabelling, we have detected DNA adducts in the liver of carp (Chondrostoma nasus) from the River Rhône (France), both downstream and upstream from a polychlorinated biphenyl incineration plant. Some of the DNA adducts were specific to downstream fish, suggesting a differential pattern of exposure. We have also detected DNA damage in needles in a declining spruce forest. We found that, in the declining forest, the amounts of DNA adducts increase in relation to the degree of damage to the needles whereas, in a healthy forest, the levels of DNA adducts were low. We have also found DNA adducts in the leaves of hops grown in fields where heptachlor residues persisted.